Thursday, May 21, 2015

10 tips on living with food allergies

Lil J has food allergies. He used to throw up after we fed him egg yolk when he was a baby, and he had pretty bad eczema. There was a period of time where he didn't gain weight for a couple of months, and we went half crazy trying to figure out what was wrong. We tried systematically eliminating foods from his diet, kept a food log, and continued monitoring. We went gluten-free, egg-free, dairy free… it became quite a headache to cook for the kid! Finally we consulted a PD (we were overseas then), and was given the wrong diagnosis that the boy was allergic to both milk and egg. The poor kid was given hydrolyzed formula, which he refused to drink (it smelled and tasted really strange, to be honest), and we totally took him off dairy products.

After moving back to Singapore, we decided to get a second opinion. Some mothers recommended Dr Lee Bee Wah, an allergist over at Mount Elizabeth, and she ran the skin prick test for Lil J for common allergens (milk, soy, nuts, egg). It turned out the first diagnosis was wrong: Lil J was not allergic to dairy! (Hooray for ice-cream and cheese!) The test did confirm an egg allergy though.

Now that he's three and a half, Lil J still has not outgrown the egg allergy. There have been instances where he's mistakenly eaten food that contained egg (usually when we are eating out, more of that in another post), after which he starts to rash all over and his eyes start to swell. There was one time when he grabbed the egg off hubby's breakfast plate when we were overseas and took a bite (this boy loves trying everything off our plates, which really gives me a heart attack because of the allergies!). Later his eyes puffed up so bad he could could barely see out of them, and the symptoms only subsided after a dose of Zyrtec.

We also discovered along the way that the kid is also allergic to prawns. He tried prawns previously when we were up in Penang to escape the haze, and started rashing all over, and again, only a dose of antihistamine helped to relieve his symptoms. He also reacts upon eating similar foods like prawn mantis.

Now Baby J seems to be showing signs of having food allergies too (he has been rashing up after certain meals, but it isn't an egg allergy since our meals are egg-free), so it's going to be another round of pin-pointing the culprit(s).

So here's what we've learnt the past few years on bringing up kids with food allergies:

1. Don't mix up food allergies and food intolerances.

Food allergies occur because the person's immune system reacts against certain chemicals in food, and these chemicals tend to be proteins. They are different from food intolerances, which are non-immune reactions (for example, lactose intolerance is different from a milk protein allergy). The treatments and approaches would be different.

If you suspect your child has a food allergy (he has rashes, has trouble breathing, or starts wheezing after certain meals, or he has eczema), eliminating the suspected food that causes the allergy would be the easiest (and cheapest way) to manage the allergy. Trying to pinpoint the cause can be tricky though, since meals can have many ingredients (and if you eat out, you may not know the entire list of ingredients). A food log in this case can be helpful (though somewhat troublesome to keep), since you can look back at all the things your child has consumed and pinpoint what foods might be triggering off the reaction.

3. If the food log isn't helpful, getting tested might give you answers. But please see an allergist if possible.

We were really going crazy trying to figure out Lil J's allergies, and the initial wrong diagnosis made it even harder for us to prepare his meals. One tricky thing about pin-pointing allergies in young children is that many of them are still breast-feeding, which means the mother's diet also affects the child (so you might have to keep a food log for yourself too!). I found that having the skin prick test and consultation with Dr Lee really cleared our doubts: I could fatten the boy up on yoghurt and cheese, and now we were very sure that the kid had to stay clear of eggs.

4. Focus on what your child CAN eat. Not what he cannot.

Initially after we confirmed the egg allergy, I felt a huge sense of relief knowing what we were dealing with. However, that was followed with weeks of feeling frustrated that I couldn't prepare meals that had egg, since eggs were quite a staple in our meals. Junior J used to be a really picky eater, and eggs were the easiest form of protein to get into him (he took ages to chew meat!). Also, I was making bentos for him, and eggs (with their cheery yellow colour) tend to be an staple in these.

However, I realized that harping on the whole "it's so hard to live with allergies" thing didn't help, and there were so many other things that Lil J could eat! For example, we would use cheese in bentos for protein and to add that pop of yellow colour, and sometimes, I would do an extra dish separately for the rest of us that contained egg. Having to prepare two different meals felt troublesome, but I figured my way around that later.

Also, don't apologize to your child that he cannot have this or that. We've had grandparents tell the kid they are sorry that he can't eat this dish or that cake, which tends to brings his focus to what he can't have (and usually makes him feel worse), rather than what he CAN have. Got a party to attend, and the kid can't eat cake? Bring a special treat for him to eat (Those chocolate surprise eggs are great if your child can have dairy).

5. Your child might still be able to have food that he normally cannot eat. You just have to figure it out.

One difficulty of having an egg allergy is that many sweet treats that children like contain eggs. Most cakes and cookies usually contain egg, and certain brands of ice-cream contain egg. We managed to find places or bakers that made egg-free cakes, however, recently I decided to make my own, since that really helped us to save (click here for our tried and tested recipe for a very yummy eggless, no-bake chocolate cheesecake). We also found places that served egg-free ice-cream (eg. Baskin Robbins and Udders), and we now also make eggless pancakes for breakfast. If you bake, you can replace the egg with alternatives (click here for a very useful list).

It wasn't so hard for the prawn allergy. However, there were certain foods (other than prawns itself) the boy had to stay away from: Penang laksa, because belacan and hae gor (prawn paste) were used, and various soups that cooked prawn shells as a base. We learnt to cook our own laksa (and omitted the belacan and hae gor), and figured how to make Italian seafood soup without the prawns (we use this recipe, but omit the shrimp and increase the amount of squid used).

6. You must read labels.

We've learnt that eggs can be sneaky: they turn up in all sorts of foods. Homemade marshmallows typically contain egg (but the cheaper, store-bought types don't), and some pastas don't contain egg as an ingredient but may contain traces of egg (because of cross contamination in factories that manufacture multiple food products. This also applies for nuts.). Many white sauces and dressings (eg. mayonnaise and tartar sauce) contain egg. Meatballs from Ikea contain egg too! Reading labels always help to clear up doubts, and over time you get the hang of what foods your child can or cannot have.

7. Train your kid to always ask before eating.

After a few scares, Lil J has learnt to always check with us before trying new dishes or foods offered by others. This boy is a foodie, and loves trying new stuff. He used to like to grab stuff off our plates to try, but has learnt (the hard way unfortunately) that he needs to check if the meal has something he cannot eat.

8. Friends and family must be educated too.

Once Lil J was wandering around the playground during a co-op session, and asked another mother if he could try the food she was feeding her son. It turned out to be fried rice, which was fried with egg. Thankfully the mum had the foresight to ask if it was ok to let him try it! (Which is why point 7 is really important if your child is old enough.)

The thing is, most kids don't have allergies, and sometimes friends don't really think twice about offering children ice-cream or cake with good intentions. If your child has an allergy, please let your friends know, and keep a watchful eye on your kids, especially on play-dates if your kids would sit together for a meal. I've had cases where kids would offer their food to Lil J, or Lil J would ask to try their food, so it's safer to watch out!

Also, I find that relatives too may not be clear about what foods are ok to offer. I've had relatives try to feed Lil J store bought chocolate cake, saying that it's just chocolate, and that it's just a taste. (Grandparents in general are known to feed yummies to their grandkids without their parents approval, right?) In most cases, I've resorted to exaggeration, because in many cases explaining to them just doesn't seem to work. I tell them they can kill him if they feed him stuff without checking with us (which is the case for kids who have anaphylactic reactions to their allergies).

If your child has allergies, then chances are you might have to cook meals for him when you are eating out. It's a lot easier if you freeze extra portions of meals that you are already having at home: pasta sauces, soups, sandwich fillings like pulled pork etc. This way, you just need to defrost his meal and steam it up before heading out. Eating out with food allergies has it's challenges, so I'll be writing a separate post on that soon.

Also, if you have children who don't have the same allergies, freezing food means that you can serve the forbidden food to the other family members, with little chances of cross-contamination. I usually prepare muffin tin frittatas (our recipe here) over the weekend, and freeze these for Junior J to put in his lunchbox when we are out. I heat them up in the toaster, and don't have to worry about contaminating Lil J's meal.

Junior J's lunch, with a muffin tin frittata.
Lil J gets the same, but without the frittata.

10. Always carry your meds with you.

We've learnt this the hard way: we've had to scramble to buy Zyrtec a few times before when Lil J develops an allergic reaction when eating out. Please carry antihistamines (or the epipen if necessary) if you decide to eat out and your child has food allergies. This is even more so if the allergies are severe (but I'm sure parents of kids with severe allergies would already know that), or if you are traveling, since you may not have easy access to a pharmacy!

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I've found that once you get used to it, living with food allergies isn't that difficult. However, this is in our case where the allergies are limited to two food types, and the reactions are not severe. I'll share more about things to note when eating out, as well as some resources I've found useful in future post. Meanwhile, for those with kids who have allergies… do share your tips if you can, and do read this post and this post for more information on food allergies.

PS: Like I've mentioned, Lil J's allergies are not severe. For those with children with serious food allergies, our tips still apply, but please take any advice with caution.

1 comment:

Lil Pumpkin doesn't have any food allergies, but she does have eczema which can flare up pretty badly. It really is important to have meds with you at all times, especially during travel and even to places where you think you might not need them e.g. friend or family member's home.

If the kid goes to sch, even the school and classmate mums should be informed on what they can/ cannot eat as well as how to react if the allergies flare up too I reckon :)

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